Posted on March 21, 2016
What is COPD?
Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. The disease is characterized by increasing breathlessness.
Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD, says the Mayo Clinic. Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs (alveoli) of the lungs. It’s characterized by daily cough and sputum production. Emphysema is a condition in which the air sacs (alveoli) at the end of the smallest air passages (bronchioles) of the lungs are destroyed as a result of damaging exposure.
What are the Signs and Symptoms?
According to the Mayo Clinic, symptoms of COPD often don’t appear until significant lung damage has occurred, and usually worsen over time—particularly if smoking exposure continues. For chronic bronchitis, the main symptom is a daily cough and sputum production at least three months a year for two consecutive years.
Other signs and symptoms of COPD include:
- Shortness of breath, especially during physical activities;
- Chest tightness;
- Having to clear your throat first thing in the morning, due to excess mucus in your lungs;
- A chronic cough that produces sputum that may be clear, white, yellow or greenish;
- Blueness of the lips or fingernail beds (cyanosis);
- Frequent respiratory infections;
- Lack of energy; and
- Unintended weight loss (in later stages).
Those with COPD are also likely to experience episodes called exacerbations, during which their symptoms become worse than usual day-to-day variation and persist for several days.
How Common is COPD?
COPD affects an estimated 24 million individuals in the U.S., and over half of them have symptoms of COPD and do not know it according to the COPD Foundation. Early screening can identify COPD before major loss of lung function occurs.
Risk Factors and Common Causes
Most cases of COPD are caused by inhaling pollutants—that includes smoking (cigarettes, pipes, cigars, etc.), and second-hand smoke. Fumes, chemicals, and dust found in many work environments are contributing factors for many individuals who develop the disease.
Genetics can also play a role in an individual’s development of COPD—even if the person has never smoked or has ever been exposed to strong lung irritants in the workplace.
The top three risk factors for developing COPD are:
COPD most often occurs in people 40 years of age and older with a history of smoking. These may be individuals who are current or former smokers. While not all those who smoke get COPD, most who have COPD (approximately 90% of them) have smoked.
COPD can also occur in those who’ve had long-term contact with harmful pollutants in the workplace. Some of these harmful lung irritants include certain chemicals, dust, or fumes. Heavy or long-term contact with secondhand smoke or other lung irritants in the home, such as organic cooking fuel, may also cause the disease.
Even if an individual has never smoked or been exposed to pollutants for an extended period of time, they can still develop COPD. Alpha-1 Antitrypsin Deficiency (AATD) is the most commonly known genetic risk factor for emphysema. Alpha-1 Antitrypsin related COPD is caused by a deficiency of the Alpha-1 Antitrypsin protein in the bloodstream. Without this protein, white blood cells begin to harm the lungs and lung deterioration occurs. The World Health Organization and the American Thoracic Society recommends that every individual diagnosed with COPD be tested for Alpha-1.
Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, and test results. He may ask whether you smoke or have had contact with lung irritants, such as secondhand smoke, air pollution, chemical fumes, or dust.
If you have an ongoing cough, let your doctor know how long you’ve had it, how much you cough, and how much mucus comes up when you cough. Also, let your doctor know whether you have a family history of COPD.
Your doctor will examine you and use a stethoscope to listen for wheezing or other abnormal chest sounds. He may recommend one or more tests to diagnose the disease:
Lung Function Tests
Lung function tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood.
The main test for COPD is spirometry. Other lung function tests, such as a lung diffusion capacity test, also might be used.
During this painless test, a technician will ask you to take a deep breath in. Then, you’ll blow as hard as you can into a tube connected to a small machine. The machine is called a spirometer. The machine measures how much air you breathe out. It also measures how fast you can blow air out. Your doctor may have you inhale medicine that helps open your airways and then blow into the tube again. He can then compare your test results before and after taking the medicine.
Spirometry can detect COPD before symptoms develop. Your doctor also might use the test results to find out how severe the disease is and to help set treatment goals. The test results also may help find out whether another condition, such as asthma or heart failure, is causing your symptoms.
Your doctor may recommend other tests, such as:
- A chest X-ray or chest CT scan: The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms.
- An arterial blood gas test: This test measures the oxygen level in your blood using a sample of blood. The results can show how severe your COPD is and whether or not you need oxygen therapy.
COPD has no cure; however, lifestyle changes and treatments can help you feel better, stay more active, and slow the progress of the disease.
Goals of treatment include:
- Relieving your symptoms;
- Slowing the progress of the disease;
- Improving your exercise tolerance (your ability to stay active);
- Preventing and treating complications; and
- Improving your overall health.
Quitting smoking is the most important step you can take to treat COPD. Talk with your doctor about following an eating plan that will meet your nutritional needs. Your doctor may suggest eating smaller, more frequent meals; resting before eating; and taking vitamins or nutritional supplements.
A few simple changes can help you manage COPD and its symptoms. For example:
- Perform activities slowly.
- Put items you need often in one place that’s easy to reach.
- Find very simple ways to cook, clean, and perform other chores. For example, you might want to use a small table or cart with wheels to move things around and a pole or tongs with long handles to reach things.
- Ask for help moving things around in your house so you won’t need to climb stairs as often.
- Keep your clothes loose, and wear clothes and shoes that are easy to put on and take off.
Depending on how severe your disease is, you may want to ask your family and friends for help with daily tasks.
New COPD Clinical Trial
CCHC New Bern Internal Medicine Specialists is pleased to offer a new clinical trial for COPD. If you are a current or former smoker living with COPD, which includes chronic bronchitis and emphysema, you may qualify for this clinical research study. To participate, you must:
- Have a history of heart disease or stroke OR
- Have cardiovascular risk factors such as diabetes, high blood pressure, high cholesterol, obesity, or kidney disease.
If you qualify, you may receive study-related:
- Physical exams;
- Blood work;
- Pulmonary function testing;
- Study medications; and
- Payment for time and travel.
Contact New Bern Internal Medicine Research Coordinators at (252) 639-5984 or (252) 639-2480 for more information.
(Sources: COPD Foundation; American Lung Association, Mayo Clinic, National Heart, Lung and Blood Institute (NIH); World Health Organization (WHO); and COPD.com.)